Use of a hand-assisted laparoscopic surgical technique for closure of an extensive mesojejunal rent in a horse

Witte, Thomas H.; Wilke, Markus; Stahl, Christina; Jandová, Vendula; Haralambus, Rhea; Straub, Reto (2013). Use of a hand-assisted laparoscopic surgical technique for closure of an extensive mesojejunal rent in a horse. Journal of the American Veterinary Medical Association, 243(8), pp. 1166-1169. American Veterinary Medical Association 10.2460/javma.243.8.1166

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CASE DESCRIPTION A 7-year-old 573-kg (1,261 -lb) Swiss Warmblood gelding was evaluated because of signs of acute abdominal pain. CLINICAL FINDINGS Physical examination revealed a markedly distended abdomen with subjectively reduced borborygmi in all abdominal quadrants. A large, gas-distended viscus was present at the pelvic brim preventing complete palpation of the abdomen per rectum. Ultrasonographic evaluation could not be safely performed in the initial evaluation because of severe signs of abdominal pain. TREATMENT AND OUTCOME Ventral midline celiotomy was performed, and right dorsal displacement of the ascending colon was corrected. Progressive signs of abdominal pain after surgery prompted repeat ventral midline celiotomy, and small intestinal incarceration in a large, radial mesojejunal rent was detected. The incarceration was reduced, but the defect was not fully accessible for repair via the celiotomy. Repair of the mesenteric defect was not attempted, and conservative management was planned after surgery; however, signs of colic returned. A standard laparoscopic approach was attempted from both flanks in the standing patient, but the small intestine could not be adequately mobilized for full evaluation of the rent. Hand-assisted laparoscopic surgery (HALS) allowed identification and reduction of jejunal incarceration and repair of the mesenteric rent. Although minor ventral midline incisional complications were encountered, the horse recovered fully. CLINICAL RELEVANCE HALS techniques should be considered for repair of mesenteric rents in horses. In the horse of this report, HALS facilitated identification, evaluation, and repair of a large radial mesenteric rent that was not accessible from a ventral median celiotomy.

Item Type:

Journal Article (Original Article)

Division/Institute:

05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > Equine Clinic
05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > DKV - Clinical Radiology

UniBE Contributor:

Witte, Thomas; Stahl, Maria Christina and Straub, Reto

Subjects:

600 Technology > 630 Agriculture

ISSN:

0003-1488

Publisher:

American Veterinary Medical Association

Language:

English

Submitter:

Susanne Portner

Date Deposited:

22 Aug 2014 13:35

Last Modified:

14 Oct 2015 11:16

Publisher DOI:

10.2460/javma.243.8.1166

PubMed ID:

24094265

BORIS DOI:

10.7892/boris.44220

URI:

https://boris.unibe.ch/id/eprint/44220

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